Acid Reflux

 

Acid reflux or gastro-esophageal reflux disease (GERD) is a common condition affecting at least 1 in 10 Singapore residents. While some GERD cases can be easily treated with a short course of antacids, H2-receptor antagonists (H2RAs) or proton-pump inhibitors (PPIs), up to one-third of patients continue to be bothered by reflux symptoms despite adequate medications. 

While heartburn and regurgitation are classic GERD symptoms, some patients may also experience pain, throat discomfort, hoarseness of voice and nausea. It is important to identify patients with alarm symptoms who will require early endoscopy to exclude a gastrointestinal cancer.

 

Alarm symptoms:

  • Unexplained weight loss

  • Difficult or painful swallowing 

  • Persistent vomiting

  • Digestive tract bleeding such as passing out blood/black stool or vomiting blood       

  • Iron deficiency anemia

  • Persistent abdominal pain

  • Family history of gastrointestinal cancer

  • Older age

In addition to correct use of appropriate anti-GERD medications, treatment of GERD also requires patients to undergo dietary and lifestyle changes. Rarely, surgery or advanced endoscopic therapy is utilised to treat severe GERD not responding to medications.